Healthcare Provider Details

I. General information

NPI: 1659934396
Provider Name (Legal Business Name): EMILY FRANCIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 EXECUTIVE PARK DR STE 7
WESTON FL
33331-3634
US

IV. Provider business mailing address

15051 S TAMIAMI TRL STE 203
FORT MYERS FL
33908-5182
US

V. Phone/Fax

Practice location:
  • Phone: 954-385-1544
  • Fax: 954-385-1533
Mailing address:
  • Phone: 239-313-2517
  • Fax: 239-666-3051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9114054
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: